Definitive Radiotherapy with or without Concomitant or Induction Chemotherapy in Patients with Hypopharyngeal Squamous Cell Carcinoma: A Single Center Study in Iran

Background: Hypopharyngeal carcinoma (HPC) is a rare head and neck cancer which poses many therapeutic challenges. There is limited evidence regarding the outcomes of HPC treatment in Iran.Method: In this retrospective cohort study, we evaluated patients treated with chemoradiation or radiation alone, between ۲۰۰۷ and ۲۰۱۶ in the radiation oncology ward of the cancer institute affiliated to Tehran University of Medical Sciences. The design of the study was reviewed and approved by the local institutional review board (code: ۸۶۱۰۰۱۴۲). All patients underwent definitive radiotherapy with or without concurrent or sequential chemotherapy. We assessed the two-year overall survival (OS) as the primary outcome. The progression-free survival (PFS) was our secondary outcome.Results: We studied ۴۰ patients whose median age was ۵۸ years. ۳۷ patients were stage ۳ or ۴, while the most common stage was T۳N۱-۲, observed in ۳۵% of the cases. The most common site of involvement was pyriform sinus (۴۷.۵%). The twoyear OS rate was ۲۹%. The two-year PFS was ۲۲%. In the univariate analysis, N۰-۱ vs. N ۲-۳ and stage ۲ vs. stage ۳-۴ were significant predictors of OS. In addition, distant metastasis had almost a significant association with lower OS.Conclusion: The outcome of locally advanced HPC was not promising using ۳DCRT alone. It is necessary to implement dramatic changes in the management of these patients to achieve better outcomes.